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Federal forms, ICRs, and supporting documents

Information Collection

Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information

IC 243485 under ICR 202512-0906-006 · OMB 0906-0058.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 STAR LRP Authorization for Disclosure of Loan Information Form STAR LRP Auth of Disc of Loan Info Form.pdf Yes Yes Fillable Fileable

Health Health Care Services

09–15–0037, HHS/HRSA/BHW Scholarship and Loan Repayment Program Records  86 FR 28362

1,700 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,700 0 -1,500 0 0 3,200
Annual IC Time Burden (Hours) 850 0 -750 0 0 1,600
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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